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General NPI Number Information
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NPI Number | 1538794797
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Entity Type | Individual
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Provider Name | MARITES M SICAT
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Gender | Female
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Dates
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Enumeration Date | 03/09/2020
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 1710 S AMPHLETT BLVD STE 112
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City | SAN MATEO
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State | CA
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Zip | 94402-2704
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Country | US
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Telephone | 650-286-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 851 BURLWAY RD STE 523
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City | BURLINGAME
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State | CA
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Zip | 94010-1714
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Country | US
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Telephone | 650-581-1359
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT27764
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License Number State | CA
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